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Nationwide rates for HCPCS A5514

For diabetics only, multiple density insert, made by direct carving with CAM technology from a rectified CAD model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of Shore A 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.99 / $36.31 / $57.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.91 / $33.88 / $47.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.90 / $41.69 / $100.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $32.36 / $67.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.48 / $35.48 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.70 / $25.70 / $77.62
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.05 / $32.36 / $43.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $26.92 / $44.67